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Diagnostic Delay of Narcolepsy: Contributing Factors and Implications for Clinicians

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Abstract

Purpose

Narcolepsy is a lifelong condition affecting one person per every 2000 worldwide. It is widely underrecognized and most are not diagnosed until 10–15 years after initial symptom onset. The purpose of this review was to provide an overview on the factors that contribute to the diagnostic delay of narcolepsy along with associated implications for clinicians.

Methods

A search of the literature in electronic databases was conducted examining data related to a diagnosis of narcolepsy. Keywords used for the search included ‘diagnosing narcolepsy,’ ‘delayed diagnosis of sleep disorders,’ etc. Of approximately 50 articles, 15 were included in this review for their relevancy and evidence, based on the Strength of Recommendation Taxonomy (SORT) system.

Results

On average, the duration in diagnostic delay was reported to be 7 years. Contributing factors included the absence of cataplexy, lack of awareness and underrecognition, presence of comorbidities and medications, limitations of and lack of consistency in current diagnostic methods, and age of onset.

Conclusions

This review highlighted major contributing factors of the diagnostic delay of narcolepsy. Recommendations for clinicians included the following: (1) learn and disseminate information about narcolepsy and (2) what narcolepsy is NOT, and; (3) employ evidence-based diagnostic procedures and/or refer to specialist.

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Authors and Affiliations

  1. Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Church Professional Building, Suite 413, 98 North Broadway, Baltimore, MD, 21231, USA

    Jagriti Bhattarai

  2. VA Eastern Kansas Health Care System, Dwight D. Eisenhower VA Medical Centre, 4101 South. 4th Street Trafficway, Leavenworth, KS, 66048, USA

    Scott W. Sumerall

Authors
  1. Jagriti Bhattarai
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All authors contributed in a significant way to the manuscript and have read and approved the final version.

Corresponding author

Correspondence to Jagriti Bhattarai.

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Bhattarai, J., Sumerall, S.W. Diagnostic Delay of Narcolepsy: Contributing Factors and Implications for Clinicians. Sleep Vigilance 2, 103–109 (2018). https://doi.org/10.1007/s41782-018-0046-9

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  • DOI: https://doi.org/10.1007/s41782-018-0046-9

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